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Objective: To compare the efficacy of Probiotics with the yoghurt in the management of children with acute diarrhoea in terms of frequency and consistency of stools. Study Design: Quasi-experimental study. Place and Duration of Study: Department of Paediatric Medicine, Combined Military Hospital, Peshawar Pakistan, from Jun to Dec 2020. Methodology: Patients were allotted into three Groups A, B, or C. Group-A received a Probiotic (Bacillus Clausii), Group-B received plain yoghurt, and Group-C did not receive yoghurt or Probiotic. The outcome was an improvement in stool consistency at 72 hours. Stool consistency was assessed via Bristol stool chart along with frequency. Data were collected 72 hours after initiation of treatment. Result: The total number of patients enrolled was 159(53 in each Group). Among these, 85(53.5%) were males, and 74(46.5%) were females. There was a statistically significant association in terms of consistency (p=0.001) and term of frequency (p<0.001) in the Probiotic and Yoghurt-Group. Conclusion: The outcome in terms of consistency is almost equal in the Probiotic and Yoghurt-Group. However, Probiotic is superior to yoghurt in terms of frequency.

Objectives: To determine the diagnostic accuracy of the extended sick neonatal score (ESNS) in neonates admitted in a resource-limited neonatal intensive care unit (NICU) at Peshawar. Study Design: Cross-sectional analytical study Place and Duration of Study: Neonatal Intensive Care Unit, CMH Peshawar Pakistan, from Mar to May 2020. Methodology: Primary data was collected from 60 neonates admitted to NICU after taking consent from the parents. The receiver operating characteristic curve (ROC) was plotted to determine the clinical score (ESNS) cut-off value in predicting mortality. Result: The sensitivity and specificity of the Extended sick neonatal score to predict mortality among neonates was 93.3% and 97%, respectively, for a cut-off of 12.5. The area under the ROC curve was 0.990 (95% CI: 0.971–1.000). This was statistically significant with a p-value of <0.001 Conclusion: Extended Sick Neonatal score is an important tool that helps predict the risk of mortality of a neonate without the help of any invasive diagnostic procedure, thus enhancing the prioritization of health care to the most deserving neonates.

Objective: To study clinical profile, blood profile and culture sensitivity patterns of Salmonella typhi in paediatric patients and factors associated with multi-drug resistant pattern. Study Design: Comparative cross-sectional study. Place and Duration of Study: Paediatrics and Microbiology Department, Combined Military Hospital Peshawar from Jan 2021 to Jan 2022. Methodology: A total of 97 paediatric patients with a confirmed diagnosis of Salmonella typhi were included in the study. A detailed clinical proforma was designed to document all the symptoms this patient had since admission. In addition, all baseline blood investigations and culture sensitivity analysis were requested during clinical evaluation. Basic demographic factors were associated with the presence of multi-drug resistant disease patterns in study participants. Results: Out of 97 children in the study, 65 (67.1%) were males, while 32 (22.9%) were females The mean age of the children in our study was 9.82±3.26 years. 61 (62.8%) patients had Salmonella typhi, which was not multi-drug resistant, while 36 (37.2%) had multi-drug resistant disease. Fever was the commonest symptom reported by our study participants. No organism was found resistant to Meropenem. Statistical analysis revealed that raised C-reactive protein levels at the time of assessment had a statistically significant relationship with the presence of multi-drug resistant disease (p-value=0.001). Conclusion: A considerable number of pediatric patients with typhoid had multi-drug resistant illnesses in our study participants. Therefore, special attention should be paid to children who had raised C-reactive protein levels at the time of initial assessment.